Sonographic Accuracy as a Novel Tool for Point‐of‐care Ultrasound Competency Assessment

Bell, Colin; McKaigney, Conor; Holden, Matthew S.; Fichtinger, Gabor; Rang, Louise

doi:10.1002/aet2.10064

Cited by 13 publications

(13 citation statements)

References 14 publications

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“…This is faster than the average time found in a previous study on trainee performance on FAST exams. 12 This could be a result of several factors, but we suspect this is because of the high volume of scans completed by a single sonographer over a relatively short period of time. This is reflected in the downward trend in time to completion for both devices over the span of the study (Figure 2).…”

Section: Discussionmentioning

confidence: 99%

A comparison of handheld ultrasound versus traditional ultrasound for acquisition of RUSH views in healthy volunteers

Dewar

Hughes

et al. 2020

JACEP Open

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Few studies evaluate the use of handheld ultrasound devices for point-of-care ultrasonography in the emergency department. We hypothesized that image acquisition time and image quality are similar between a handheld device and a traditional device. We compared these 2 types of devices in healthy, non-pregnant adults with using a crossover non-inferiority design while acquiring Rapid Ultrasound for Shock and Hypotension (RUSH) view. We excluded those with a history of surgical intervention or known abnormality to the lungs, abdomen, or pelvis. Images were compiled into a de-identified video clip reviewed for image quality by 2 blinded reviewers. Cohen's Kappa was used to determine interrater agreement. Disagreements were adjudicated by an independent physician. Imaging time was compared using a paired Student's t test. Of 59 screened participants, 9 were excluded. Most subjects (N = 30, 60%) were female with a mean age of 39 (Range: 19-67) years. The median time to complete the RUSH exam did not differ (handheld 249.4, interquartile range 33.5 seconds); traditional 251.4, interquartile range 66.3 seconds); [P = 0.81]). Agreement between ultrasound reviewers was good (agreement 83%; k = 0.69; 95% CI, 0.49-0.88). Images were determined to be of adequate quality for interpretation in 41/50 (82%) and 43/50 (86%) in the handheld and traditional devices, respectively (P = 0.786). Neither time to image acquisition nor image quality differed between the handheld and traditional devices. The handheld device may be an alternative for use in RUSH exams.

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Section: Discussionmentioning

confidence: 99%

A comparison of handheld ultrasound versus traditional ultrasound for acquisition of RUSH views in healthy volunteers

Dewar

Hughes

et al. 2020

JACEP Open

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“…This is one limitation of optoelectronic devices, as already discussed in our investigation [2]. In contrast, Bell et al [3] used a different technology (electromagnetic tracking) that is free from this limitation but that can measure only a reduced number of markers.…”

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confidence: 83%

Reply to: Wanted: Automated objective proficiency assessment metrics for the FAST exam (and other POCUS studies)

Zago

Sforza

Zago

2019

Eur J Trauma Emerg Surg

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“…Alternatives that have been explored include direct observation, simulation, checklists, global rating scales, or hand motion assessment. [6][7][8][9] Each is time-consuming, resource-intensive, or expensive or has not been validated. Accordingly, none of these assessment methods are in widespread use, so there is no standardization in determining POCUS proficiency for ultrasound learners.…”

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confidence: 99%

“…As EM education transitions to a competency‐based curriculum, assessment must evolve from numeric mandates toward more objective proficiency assessment methods. Alternatives that have been explored include direct observation, simulation, checklists, global rating scales, or hand motion assessment 6,7,8,9. Each is time‐consuming, resource‐intensive, or expensive or has not been validated.…”

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confidence: 99%

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Differences in Gaze Fixation Location and Duration Between Resident and Fellowship Sonographers Interpreting a Focused Assessment With Sonography in Trauma

Bell

Szulewski

Walker

et al. 2020

AEM Education and Training

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Objectives: We quantified the gaze fixation duration of resident and fellowship sonographers interpreting a prerecorded focused assessment with sonography in trauma (FAST). We hypothesized that all sonographers would fixate on each relevant anatomic relationship but that the duration of fixation would differ. Methods: We conducted a cross-sectional study collecting and analyzing the gaze fixations of a convenience sample of current resident and fellowship sonographers. All sonographers viewed a standardized FAST video, and their gaze fixations were recorded using a Tobii X3-120 eye-tracking bar. Gaze fixations over nine anatomic regions of interest (ROIs) were identified. These were assessed for normality and analyzed using the Wilcoxon rank sum test at an alpha of 0.05 and Bonferroni correction p value of <0.0034. The chi-square test and Pearson's correlation were performed to assess statistical association. Results: The gaze fixation recordings of 24 resident and eight fellowship sonographers were suitable for analysis. Fourteen of the 24 resident sonographers viewed all ROIs in the FAST, whereas all eight fellowship sonographers viewed each of the nine relevant ROIs. Five ROIs were identified over which at least one resident sonographer did not have a gaze fixation. No statistically significant difference was identified between groups. Resident sonographers gaze fixated over the left upper quadrant (LUQ) splenorenal interface for a median (interquartile range) of 10.64 (9.73-11.60) seconds. The fellowship group viewed the same ROI for 8.43 (6.64-8.95) seconds (p < 0.003). All participants viewed this ROI. No other ROIs had a statistical difference. Conclusion: Five ROIs were identified that were not visually interrogated by all resident sonographers. Only 14 of 24 resident sonographers visually interrogated every area in the FAST, whereas all fellowship sonographers interrogated every ROI. A statistically significant difference was found in gaze fixation duration between resident

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Sonographic Accuracy as a Novel Tool for Point‐of‐care Ultrasound Competency Assessment

Abstract: Differences in probe motion efficiency and POIs scanned between novices and intermediate or returning novice users show promise for use as a quantitative objective assessment tool. Unlike in surgical literature, accuracy did not correlate with path length or time to examination completion.

Cited by 13 publications

References 14 publications

A comparison of handheld ultrasound versus traditional ultrasound for acquisition of RUSH views in healthy volunteers

A comparison of handheld ultrasound versus traditional ultrasound for acquisition of RUSH views in healthy volunteers

Reply to: Wanted: Automated objective proficiency assessment metrics for the FAST exam (and other POCUS studies)

Differences in Gaze Fixation Location and Duration Between Resident and Fellowship Sonographers Interpreting a Focused Assessment With Sonography in Trauma

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